Exercise Amaliorates Metabolic Disturbances and Oxidative Stress in Diabetic Cardiomyopathy: Possible Underlying Mechanisms

Cardiomyopathy is a serious complication of diabetes mellitus and occurs independently of coronary artery disease or hypertension. It manifests as systolic/diastolic dysfunction and hypertrophy of the left ventricle and can lead to heart failure. Hyperglycemia can trigger a series of maladaptive stimuli and result in cardiac hypertrophy, fibrosis and reduced performance and contractility. The pathogenesis of diabetic cardiomyopathy is a multifactorial process that includes metabolic derangements such as increased oxidative stress, and altered non-oxidative glucose pathways and lipid metabolism. Exercise is a useful non-pharmacological strategy effective in the reduction of diabetes and obesity risk factors, and improvement of antioxidant defenses, mitochondrial function and physiological cardiac growth. It can amend multiple metabolic derangements and alterations in the diabetic heart. Therefore, figuring out the underlying mechanisms of exercise-induced beneficial effects could help to develop new treatment strategies for diabetic cardiomyopathy.